1. Creating a placental inflammatory composite index that has a high prognostic relevance to child morbidity.
- Author
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Chen, Yan, Zou, Lile, Zhao, Yanjun, Wu, Ting, Ye, Jiangfeng, Zhang, Huijuan, and Zhang, Jun
- Subjects
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CHILDREN'S health , *DISEASES , *HOST-bacteria relationships , *INFLAMMATION , *LONGITUDINAL method , *NECROSIS , *PLACENTA diseases , *PROGNOSIS - Abstract
Aim Selecting pathologic measures of placental inflammation that affect pregnancy and childhood health is largely empirical. We aimed to systematically select several core inflammation-related placental measures to construct a novel placental inflammatory evaluation criterion with a high prognostic relevance to child morbidity. Methods We used data from the US Collaborative Perinatal Project (1959-1976), a longitudinal birth cohort study that recruited women during pregnancy and followed the children until 7 years of age. Bootstrap resampling, least absolute shrinkage and selection operator, and receiver-operator curve were used to select placental pathologic measures that were closely related to child morbidity to form a placental inflammatory composite index. Results Twenty-six candidate placental inflammation-related measures were ranked based on their close association with adverse neonatal outcomes. The top five placental measures were: (i) neutrophilic infiltration in umbilical artery; (ii) placental weight-birthweight ratio; (iii) necrosis in decidua capsularis; (iv) bacterial colony in epithelium of amnion; and (v) opacity of membranes and fetal surface. Several composite indexes were constructed. A five-measure composite index that had the highest prognostic relevance was chosen. Compared with subjects without any of the five abnormal measures, those with any lesion ranging from 1 to 5 had a 1.2- to 4.6-fold risk of adverse child outcomes, respectively. Conclusion Our composite index is simple, evidence-based, and has predictive value for child morbidity. It may be used as a novel placental inflammatory evaluation criterion. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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